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Nosebleeds (epistaxis) are a common childhood condition, that are usually self-limiting and one that children normally grow out of by around 11 years of age . They are commonly caused by minor injury to the lining of the nose and this can be caused by picking or banging the nose. They can also occur if your child has had a recent cough/runny nose (viral upper respiratory tract infection), if they have allergic rhinitis, blowing the nose too hard, if the inside of the nose becomes too dry or by a foreign body in their nasal passage. Only very rarely can it be due to a bleeding disorder. The bleeding is usually from the front part of the nose and whilst the amount of bleeding may seem like a lot (such as soaking through tissues), it is rare for children to lose so much blood that it causes any problems (such as anaemia). This is only to be likely with frequent, heavy nosebleeds over several weeks or months.
The advice below should help you decide whether your child’s nosebleed requires further help or whether it can be managed by yourself at home.
Your child may require emergency treatment.
You should call 999 or take them to your nearest Children’s A&E where they can be assessed.
Your child does not need to be rushed to A&E but you should seek medical advice today.
You can:
If your child develops any symptoms in the Red Box above, click and follow advice for that symptom.
Care using the advice below, can be provided to your child at home if none of the above features are present. If your child continues to get frequent nose bleeds, please arrange to speak to your GP or practice nurse.
You child does not seem to have any symptoms of serious illness or injury.
You can get general advice on the NHS website or from your local Pharmacy.
If your child develops any of the symptoms in the Red or Amber boxes above, click on that symptoms and follow the advice.
If the bleeding has stopped by the first aid measures you have applied, then for the next 24 hours your child should be advised:
You can treat your child's very minor illnesses and injuries at home.
Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.
Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.
For information on common childhood illnesses go to What is wrong with my child?
Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.
Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.
Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.
Contact them by phoning your Health Visitor Team or local Children’s Centre.
Health visitors also provide advice, support and guidance in caring for your child, including:
For more information watch the video: What does a health visitor do?
School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.
Contacting the School Nurse
Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.
All home educated children will have a named School Nurse.
Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.
They all have a role in preventing disease and promoting health and wellbeing, by:-
Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.
The clinical team in GP surgeries include doctors, advanced nurse practitioners and nurses who are trained to assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP surgery team will arrange a referral to a hospital specialist should you need it.
You have a choice of service:
If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.
Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.
A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.
Alder Hey Children's Charity